Atrial fibrillation and prognosis in patients 80+ years old with chronic heart failure

Aging Clin Exp Res. 2014 Feb;26(1):53-60. doi: 10.1007/s40520-013-0134-6.

Abstract

Introduction: It is well known that the prevalence of atrial fibrillation (AF) increases with age. The purpose was to evaluate the impact of AF at the 1-year outcome of patients aged 80? who suffered from chronic heart failure (CHF).

Materials and methods: The study included 220 consecutive patients at age 80–92 (mean 82.8 years, 45.5 % men) hospitalized for heart failure. The prospective analysis contains demographic and clinical data, basic laboratory tests with hsTnT and NT-proBNP, 12-lead resting electrocardiogram, echocardiography and coronary angiography results and the number of deaths at the 1-year followup. Patients were analyzed depending on AF in the resting electrocardiogram at hospital entry.

Results: AF was recorded in 52 patients (24 %). The relationship with AF was found for more advanced NYHA class III and IV (p\0.001), higher concentrations of hsCRP (p = 0.0005), hsTnT (p = 0.007) and NT-proBNP (p = 0.0098), higher heart rate in the electrocardiogram (p = 0.000) and longer hospitalization (p = 0.025), older age (p = 0.003) and lower left ventricular ejection fraction (p = 0.006). Annual mortality was 13 % and was higher if AF occurred (17 %). However, there was no association between deaths and AF (p = 0.3297). From the multivariate stepwise analysis, independent risk factors for annual mortality were male gender (OR = 3.432; p = 0.043), left ventricular systolic dimension (OR = 1.871; p = 0.004) and dyslipidemia (OR = 0.252; p = 0.043).

Conclusions: In the oldest patients aged 80? who suffered from CHF, the incidence of atrial fibrillation and annual mortality was high. The independent variables, which enhanced the risk of death at the 1-year follow-up, were male sex and left ventricular systolic dimension, but not atrial fibrillation.

MeSH terms

  • Aged, 80 and over
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / pathology*
  • Atrial Fibrillation / physiopathology
  • Chronic Disease
  • Echocardiography / methods
  • Electrocardiography / methods
  • Female
  • Heart Failure / pathology
  • Heart Rate / physiology
  • Hospitalization
  • Humans
  • Male
  • Prognosis
  • Prospective Studies
  • Ventricular Function, Left / physiology